Cholera

Cholera is a waterborne disease causing serious infection in the lower part of the small bowel. An acute inflammatory disorder caused by the bacterium known as Vibrio cholerae in the intestines results in cholera. Cholera is also known as Asiatic cholera or epidemic cholera. The disease is predominant in endemic areas like India and other countries of Southeast and Mid East Asia. This disease strikes as an epidemic and creates havoc, but subsides quickly in the locality.

Cholera usually strikes during the monsoon and is known to make a sudden appearance.It has a short incubation period, from less than one day to five days, and produces an enterotoxin that causes a continuous, painless, watery diarrhea that can quickly lead to severe dehydration and death if treatment is not promptly provided.

Cholera continues to be a global threat and can be considered as one of the key indicators of social development. The disease is not so much a threat to countries with minimum standards of hygiene; it remains a challenge to countries where access to safe drinking water and adequate sanitation cannot be guaranteed. A Cholera outbreak is a fearful epidemic in almost every developing country.

Symptoms of Cholera:

A disorder of any kind within the system is made known by warning signals by the system that indicate a disease has struck. In case of cholera, the warning signals are indicated by:

1. The first symptom is mild diarrhea followed by sudden violent purging and lack of proper control of the bowel.

2. Pain and muscle cramps in the lower abdomen

3. Nausea and vomiting

4. Watery and grayish-brown colour excreta.

The other symptoms indicating cholera include: severe dehydration and intense thirst. One may experience dryness of the tongue and the skin may tend to get wrinkled, while the eyeballs sink in and cheeks become hollow. Breathing becomes somewhat difficult. Low blood pressure due to the lack of fluids in the body. The temperature may come down to subnormal, although the pulse rate will be rapid. Prompt replacement of fluids and salts (lost through severe diarrhea and vomiting ) is the necessary to avoid death that may result from complete collapse of the circulation.Early rehydration can save the lives of nearly all cholera patients. Drinking large quantities of a solution of oral rehydration salts can rehydrate most quickly and easily.

Causes of Cholera:

The main causes of a cholera epidemic can be attributed to two main factors:

1. The existence and spread of the bacterium known as vibrio cholerae.

2. Unhygienic living conditions that are conducive to the growth of such bacteria.

Lets have a look at both these factors in detail:

Vibrio cholerae: This produces a powerful poison. It is spread by flies and water contaminated by the germs. Drinking water or eating food contaminated by the bacterium can infect a person. Common sources of food borne infection include raw or poorly cooked seafood, raw fruit and vegetables, and other foods contaminated during preparation or storage. Bacteria present in the faeces of an infected person are the main source of contamination. The bacterium can also live in the environment in brackish rivers and coastal waters.

Unhygienic Living Conditions: These are the main cause of bringing about the bacterium’s harmful effects to the society by incorrect consumption habits and disoriented style of living. Inadequate water supplies, sanitation, food safety, and hygiene are key indicators of unhygienic living conditions. Overpopulated communities, refugee settings and scarce resources to meet the basic requirements lead to poor sanitation and lack of hygiene. Cholera can spread rapidly in areas where sewage and drinking water supplies are inadequately treated and facilitates the invasion of cholera in the society.

Diet for Cholera:

The information provided by the World Health Organization (WHO) with regard to prevention and control of cholera states that: ‘When cholera occurs in an unprepared community, case-fatality rates may be as high as 50% -- usually because there are no facilities for treatment, or because treatment is given too late. In contrast, a well-organized response in a country with a well established diarrhoeal disease control programme can limit the case-fatality rate to less than 1%’

Thus this potentially fatal epidemic can be less fatal by employing simple means. Knowledge of the symptoms and methods of treatment are crucial in this context. The very first symptom of dehydration can be attended to by simple methods and therefore eliminate the possibility of the fatal effects of cholera. Dehydration caused by cholera leads to malfunctioning of other organs in the system. Therefore prompt replacement of fluids and salts (lost from the body by diarrhea or vomiting) must be the first step towards combating Cholera. Here are some easy and simple steps to combat dehydration:

1. To quench the thirst one should resort to dinking water, soda water or coconut water. Diarrhea and vomiting could cause the water intake to be thrown out of the system; hence it is advisable to consider taking only small quantities of water. Small intake can increase the possibility of the water remaining within the stomach for a longer period. The more the ability of the water to subsist the more the possibility of water getting absorbed and avoiding dehydration to take place.

2. Sucking on ice at regular intervals can reduce internal temperature and restrict the tendency to vomit.

3. Dehydration can also be reversed with intravenous infusions of saline solution to compensate for the loss of fluids and salts from the body. One may require two litres or more a day. Potassium may be added to the fluids, if there are signs of loss of this mineral.

4. Once the acute stage of cholera is done with one can resort to drinking green coconut water and barley water in very thin liquid form. When the stools begin to get more solidified one can consider graduating to buttermilk. Rice softened to semi-solid form, mixed with curd can be added to the diet as one progresses towards recovery.

5. Care should be taken to avoid solid food until one has completely recovered from cholera. Liquid and bland diet foods are the best, which he can ingest without endangering a reoccurrence of the disease. It is advisable to include lemon; onion, green chillies, vinegar and mint in the routine diet during an epidemic of cholera.

Natural Remedies for Cholera:

Nature in its very own way creates the harmful bacterium and also provides certain plants and fruits that can prove beneficial to the treatment of cholera. We list a few do good natures gifts that could be of assistance when cholera strikes:

The foremost among these is the use of lemon .Now; this small fruit is known to yield many benefits. With regard to cholera it helps:

1. Terminate the cholera bacilli within a very short time.

2. Proven to be a very effective and reliable preventive food item against cholera during the epidemic.

3. It can be taken in the form of sweetened or salted beverages for this purpose. Taking of this fruit with meals daily also series as an effective preventive against cholera.

The root bark of guava is another valuable remedy. It is rich in tannins and can be successfully used in the form of concentrated decoction in cholera. About 30 grams of the root bark should be used in 500 ml of water to make the decoction. The water should be boiled till it is reduced to one-third. It can be taken twice daily. It will do away with vomiting and symptoms of diarrhoea.

Another effective remedy for cholera is the use of the leaves and flowers of peach. They should be taken in the form of syrup or conserve. The leaves of drumstick tree are also useful in this disease. Half a teaspoon of fresh leaf-juice, mixed with equal quantity of honey and half a glass of tender coconut water, can be given two or three times as a medicine in the treatment of cholera.

Onion is very useful in cholera. About 15 grams of this vegetable and four black peppers should be finely pounded in a pestle and consumed. It quenches thirst and restlessness and generates a feeling of well being.The fresh juice of bitter gourd is another effective medicine in early stages of cholera. A teaspoon of this juice, mixed with equal quantity of white onion juice and half a teaspoon of limejuice makes an effective remedy to combat cholera.

Other Measures:

The intense visceral congestion can be relieved by keeping warm and activating the skin. How can this be done? Simply follow one of the tried and tested methods listed below:

1. Applying hot-blanket pack or by taking hot full bath followed by vigorous cold rubbing with towel until surface is red.

2. To check vomiting, ice bag can be applied over the stomach, throat and spine.

3. Cold compresses can also be applied over the abdomen with beneficial results. They should be changed every 15 or 20 minutes.

4. Cholera can be controlled only by rigid purification of water supplies and proper disposal of human wastes.

5. In cases of slightest doubt about contamination of water, it must be boiled before use for drinking and cooking purposes.

6. All food items must be kept covered and vegetables and fruits washed with a solution of potassium permanganate before consumption.

7. Other precautions against this disease include avoiding all uncooked vegetables, thorough washing of hands by all who handle food, and the elimination of all contacts with the disease.